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  • Genotype-based dosage of acenocoumarol in highly-sensitive geriatric patients.

Genotype-based dosage of acenocoumarol in highly-sensitive geriatric patients.

International journal of clinical pharmacology and therapeutics (2015-02-12)
Roberto Lozano, María-Esther Franco, Luis López, Juan-José Moneva, Vicente Carrasco, Maria-Angeles Pérez-Layo
ABSTRACT

Our aim was to determinate the acenocoumarol dose requirement in highly sensitive geriatric patients, based on a minimum of genotype (VKORC1 and CYP2C9) data. We used a Gaussian kernel density estimation test to identify patients highly sensitive to the drug and PHARMACHIP®-Cuma test (Progenika Biopharma, SA, Grifols, Spain) to determine the CYP2C9 and VKORC1 genotype. All highly sensitive geriatric patients were taking ≤5.6 mg/week of acenocoumarol (AC), and 86% of these patients presented the following genotypes: CYP2C9*1/*3 or CYP2C9*1/*2 plus VKORC1 A/G, CYP2C9*3/*3, or VKORC1 A/A. VKORC1 A and CYP2C9*2 and/or *3 allelic variants extremely influence on AC dose requirement of highly sensitive geriatric patients. These patients display acenocoumarol dose requirement of ≤5.6 mg/week.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Ramipril, ≥98% (HPLC)
Supelco
Ramipril, Pharmaceutical Secondary Standard; Certified Reference Material
Ramipril, European Pharmacopoeia (EP) Reference Standard
USP
Ramipril, United States Pharmacopeia (USP) Reference Standard